- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $2,137.96 / $6,456.54
| Facility | | $645.65 | $2,137.96 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $478.63 / $4,786.30
| Professional | | $158.49 | $478.63 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,754.40 / $12,589.25 / $16,218.10
| Facility | | $5,754.40 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $346.74 / $912.01
| Professional | | $169.82 | $346.74 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $208.93 / $281.84
| Facility | | $194.98 | $208.93 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $501.19 / $794.33
| Facility | | $426.58 | $501.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $676.08 / $758.58
| Professional | | $251.19 | $676.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $1,047.13 / $8,709.64
| Facility | | $165.96 | $1,047.13 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $398.11 / $512.86
| Professional | | $295.12 | $398.11 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $1,047.13 / $2,818.38
| Facility | | $165.96 | $1,047.13 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $616.60 / $5,128.61
| Professional | | $190.55 | $616.60 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $891.25 / $2,344.23
| Facility | | $346.74 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $416.87 / $741.31
| Professional | | $204.17 | $416.87 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $354.81 / $537.03
| Professional | | $194.98 | $354.81 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $7,762.47 / $7,762.47
| Facility | | $3,467.37 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $234.42
| Facility | AS | $42.66 | $42.66 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $2,691.53 / $5,128.61
| Professional | | $302.00 | $2,691.53 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Professional | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $2,137.96 / $2,187.76
| Professional | | $562.34 | $2,137.96 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,659.59 / $3,467.37
| Facility | | $1,023.29 | $1,659.59 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $467.74 / $1,148.15
| Professional | | $70.79 | $467.74 | $1,148.15 |